Laryngoscopic Image Stitching for View Enhancement and Documentation - First Experiences

One known problem within laryngoscopy is the spatially limited view onto the hypopharynx and the larynx through the endoscope. To examine the complete larynx and hypopharynx, the laryngoscope can be rotated about its main axis, and hence the physician obtains a complete view. If such examinations are captured using endoscopic video, the examination can be reviewed in detail at a later time. Nevertheless, in order to document the examination with a single representative image, a panorama image can be computed for archiving and enhanced documentation. Twenty patients with various clinical findings were examined with a 70 rigid laryngoscope, and the video sequences were digitally stored. The image sequence for each patient was then post-processed using an image stitching tool based on SIFT features, the RANSAC approach and blending. As a result, endoscopic panorama images of the larynx and pharynx were obtained for each video sequence. The proposed approach of image stitching for laryngoscopic video sequences offers a new tool for enhanced visual examination and documentation of morphologic characteristics of the larynx and the hypopharynx

Edge Enhancement Optimization in Flexible Endoscopic Images to the Perception of Ear, Nose and Throat Professionals

Objectives: Digital endoscopes are connected to a video processor that applies various operations to process the image. One of those operations is edge enhancement that sharpens the image. The purpose of this study was to (1) quantify the level of edge enhancement, (2) measure the effect on sharpness and image noise, and (3) study the influence of edge enhancement on image quality perceived by ENT professionals. Methods: Three digital flexible endoscopic systems were included. The level of edge enhancement and the influence on sharpness and noise were measured in vitro, while systematically varying the levels of edge enhancement. In vivo images were captured at identical levels of one healthy larynx. Each series of in vivo images was presented to 39 ENT professionals according to a forced pairwise comparison test, to select the image with the best image quality for diagnostic purposes. The numbers of votes were converted to a psychometric scale of just noticeable differences (JND) according to the Thurstone V model. Results: The maximum level of edge enhancement varied per endoscopic system and ranged from 0.8 to 1.2. Edge enhancement increased sharpness and noise. Images with edge enhancement were unanimously preferred to images without edge enhancement. The quality difference with respect to zero edge enhancement reaches an optimum at levels between 0.7 and 0.9.Conclusion: Edge enhancement has a major impact on sharpness, noise, and the resulting perceived image quality. We conclude that ENT professionals benefit from this video processing and should verify if their equipment is optimally configured. Level of Evidence: N/A Laryngoscope, 2023.</p

Telemedicine and Telementoring in Rhinology, Otology, and Laryngology: A Scoping Review

Objective: Telemedicine and telementoring have had a significant boost across all medical and surgical specialties over the last decade and especially during the COVID-19 pandemic. The aim of this scoping review is to synthesize the current use of telemedicine and telementoring in otorhinolaryngology and head and neck surgery. Data Sources: PubMed and Cochrane Library. Review Methods: A scoping review search was conducted, which identified 469 articles. Following full-text screening by 2 researchers, 173 articles were eligible for inclusion and further categorized via relevant subdomains. Conclusions: Virtual encounters and telementoring are the 2 main applications of telemedicine in otolaryngology. These applications can be classified into 7 subdomains. Different ear, nose, and throat subspecialties utilized certain telemedicine applications more than others; for example, almost all articles on patient engagement tools are rhinology based. Overall, telemedicine is feasible, showing similar concordance when compared with traditional methods; it is also cost-effective, with high patient and provider satisfaction. Implications for Practice: Telemedicine in otorhinolaryngology has been widely employed during the COVID-19 pandemic and has a huge potential, especially with regard to its distributing quality care to rural areas. However, it is important to note that with current exponential use, it is equally crucial to ensure security and privacy and integrate HIPAA-compliant systems (Health Insurance Portability and Accountability Act) in the big data era. It is expected that many more applications developed during the pandemic are here to stay and will be refined in years to come

A high-speed quantitative analysis of vocal fold vibration in normal and dysphonic subjects

A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2007.Thesis (B.Sc)--University of Hong Kong, 2007.Also available in print.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Laryngeal sensory testing using flexible endoscopy

Sensory input from the laryngeal mucosa is vital for triggering protective airway reflexes. The laryngeal adductor reflex (LAR) is a brief vocal fold adductor reflex in response to stimulation of the laryngeal mucosa. Depressed LAR may lead to aspiration of foreign substances into the airway. Loss of laryngeal sensation has thus been considered as one of the risk factors associated with aspiration and airway complications in patients with dysphagia. Laryngeal sensation can be endoscopically tested by lightly and briefly touching a patient’s arytenoids or epiglottis with the tip of a flexible laryngoscope (the touch method). In a preliminary study, we endoscopically investigated the laryngeal sensation and swallowing ability of healthy adults and patients with dysphagia. The results indicated an association between sensory deficits as determined by the touch method and penetration/aspiration of trial boluses in both healthy adults and patients with dysphagia. However, the pressure applied to the larynx using this touch method might not be consistent, and the expected responses elicited by this method were uncertain. Study 1 of this dissertation investigated the variability in the pressure delivered by clinicians using the touch method. The study also reported on the types of various subject responses to the touches. The results revealed that there was a wide range of pressure levels exerted by examiners. This suggested the need for further research to establish the validity of this diagnostic tool. The study also showed that the LAR always occurred in response to touch in normal volunteers, suggesting that this technique may be quite sensitive at detecting sensory deficits in a person who does not exhibit an LAR in response to touch. Study 2 examined hospitalized patients with symptoms of dysphagia. The question of interest was whether an absent LAR in response to touch was associated with aspiration or pneumonia. No significant association was found between absent LAR and aspiration of food or liquid; however, a significant association was observed between absent LAR and the occurrence of pneumonia. The study indicated that the touch method has potential for predicting pneumonia in patients with swallowing problems.2017-11-07T00:00:00

Objectively Measuring Observer Attention in Severe Thyroid‐Associated Orbitopathy: A 3D Study

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149276/1/lary27447.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149276/2/lary27447_am.pd

Triggered optical coherence tomography for capturing rapid periodic motion

Quantitative cross-sectional imaging of vocal folds during phonation is potentially useful for diagnosis and treatments of laryngeal disorders. Optical coherence tomography (OCT) is a powerful technique, but its relatively low frame rates makes it challenging to visualize rapidly vibrating tissues. Here, we demonstrate a novel method based on triggered laser scanning to capture 4-dimensional (4D) images of samples in motu at audio frequencies over 100 Hz. As proof-of-concept experiments, we applied this technique to imaging the oscillations of biopolymer gels on acoustic vibrators and aerodynamically driven vibrations of the vocal fold in an ex vivo calf larynx model. Our results suggest that triggered 4D OCT may be useful in understanding and assessing the function of vocal folds and developing novel treatments in research and clinical settings

A preliminary study of a quantitative analysis method for high speed laryngoscopic images

High speed laryngoscopic study provides new information on the vocal fold vibratory patterns which has not been made possible before. Qualitative analysis of high speed laryngoscopic images is commonly reported in the literature. However, quantitative studies are necessary to provide objective measures for research and clinical purposes. This study reports the development of the High Speed Video Processing Program in analysing high-speed laryngoscopic video images obtained from 15 non-dysphonic speakers. Nine glottal ratio indices that represented the full opened glottal area, glottal width and glottal length were computed using the processing program. Data from two dysphonic participants were included to illustrate the manifestation of these glottal measures in dysphonic voices. Some of these glottal ratio index measures showed high variability across participants. However, significant differences were found in a number of index measures among the creaky, modal and falsetto registers in the non-dysphonic participants. In addition, the glottal area ratio index was found to be specifically sensitive in detecting dysphonia in high speed glottal images. The proposed semi-automatic High Speed Video Processing Program showed value in the analysis of high speed laryngoscopic images. © 2010 The Speech Pathology Association of Australia Limited.postprin